Healthcare Provider Details

I. General information

NPI: 1144862426
Provider Name (Legal Business Name): APC-LSMA DESIGNATED SHAREHOLDER MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1658 W VALLEY BLVD STE 120
ALHAMBRA CA
91803-2370
US

IV. Provider business mailing address

1668 S GARFIELD AVE FL 2
ALHAMBRA CA
91801-5400
US

V. Phone/Fax

Practice location:
  • Phone: 626-282-0282
  • Fax: 626-282-0939
Mailing address:
  • Phone: 626-282-0282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS S LAM
Title or Position: CEO
Credential: MD
Phone: 626-282-0282